The Diagnosis of Wear Patterns
This section reviewed how tooth wear occurs in relation to how it can be treated.
· The pattern of wear often gives us clues as to what treatment can be completed.
· Sometimes tooth wear occurs only in one area, like the anterior or posterior.
· In this case, the bruxing habit may be protrusive in nature. There may also be a very steep jaw joint (so they can’t wear their posterior teeth). They may also have an erosive habit that only contacts their anterior teeth.
· In this case, vertical dimension is likely not lost.
· A treatment planning error would be to increase the VDO.
· In a second case, there is more posterior wear than anterior wear.
· This can often be caused by gastric reflux, or citrus fruit mulling, or bruxism with an anterior open bite.
· The patient that would most likely need their bite opened is the patient that has even wear on all of their teeth.
· This will be dictated by the patient’s face. Where their incisal edges are located play a large role in the planning.
· A unilateral bruxism pattern can be difficult to treat without crown lengthening or orthodontic intrusion.